(NIH) - 3/27/2013 - At 7 months of age, children who are later diagnosed with autism take a split second longer to shift their gaze during a task measuring eye movements and visual attention than do typically developing infants of the same age, according to researchers supported by the National Institutes of Health.
The difference between the groups’ test results was 25 to 50 milliseconds on average, the researchers found, too brief to be detected in social interactions with an infant. However, they showed that this measurable delay could be accounted for by differences in the structure and organization of actively developing neurological circuits of a child’s brain.
Efficiently shifting attention early in infancy is thought to be important for later social and cognitive development. Split-second delays, the researchers suggested, could be a precursor to such well known symptoms of autism as difficulty making eye contact or following a parent’s pointing finger, problems that generally emerge after a child turns 1. Typically, autism spectrum disorder (ASD) is not diagnosed until after 3 or 4 years of age.
“This study ties a difference in reaction times to differences in the developing brain, which may shape the way babies take in and respond to their environment in more noticeable ways over time,” said Alice Kau, Ph.D., of the Intellectual and Developmental Disabilities Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the institute that funded the research. “The brain’s pathways for communication are forming rapidly in early infancy, and small differences at this stage could foretell greater difference at a later age.”
First author Jed T. Elison, Ph.D., of the University of North Carolina at Chapel Hill (UNC) and California Institute of Technology, Pasadena, collaborated with senior author Joseph Piven, M.D., of UNC, and researchers from The Children’s Hospital of Philadelphia and the University of Pennsylvania, Philadelphia; the University of Texas at Dallas; Washington University, St. Louis; the University of Washington, Seattle; the University of Utah, Salt Lake City; McGill University, Montreal; and the University of Alberta, Canada.
The study appears in the American Journal of Psychiatry.
The research is part of the ongoing Infant Brain Imaging Study, which is supported through the NICHD’s Autism Centers of Excellence Program.
To measure shifts in gaze and visual attention, the researchers used sophisticated eye tracking equipment to capture the precise timing of eye movements. The infants sat on their parent’s laps and watched images appear on a computer monitor. The test procedure used in the study is known as the gap/overlap task. In one part of the test, an image would appear in the center of the screen to attract the infant’s gaze, and would then disappear. After a brief delay, or gap, another image would appear at the edge of the screen.
In another part of the test, the central image remained on the screen, and an image appeared at the periphery of the screen. The researchers measured the time it took infants to initiate an eye movement to the image in the periphery. In addition to the eye tracking task, the 7-month-old infants took part in a type of magnetic resonance brain imaging called diffusion weighted imaging, which measures the organization of neural circuits in the brain.
Fifty-seven infants had an older sibling diagnosed with autism, and so were considered at higher risk for developing autism themselves. The study also included 40 infants who did not have an older sibling with autism and so were considered at low risk for developing autism. All of the children returned to the study facility after their second birthdays for clinical assessments. By this time, 16 of the high-risk children were classified as having ASD. Based on the classification during the clinical assessment visit, the researchers compared the brain imaging data and the eye tracking data collected at 7 months across three groups:

Children with an older sibling with ASD who themselves were classified with ASD (high-risk positive)

Children with an older sibling with ASD who were not classified with ASD (high-risk negative)

Children who did not have an older sibling with ASD (low risk)

During the overlap condition of the eye tracking task, in which presentation of the central image overlapped with the appearance of the image at the edge of the screen, the researchers found a notable difference in the time it took for the high-risk positive infants to shift their gaze, compared to the other groups of infants.
The researchers uncovered evidence that the functioning of a key brain structure may account for the differences in gaze shifting between the groups. The brain structure is called the splenium of the corpus callosum. This structure is considered to be an important neural connection between the two hemispheres of the brain.
In the low-risk infants, the researchers found that the speed with which the infants shifted their gaze was closely associated with the size of the splenium. The greater the size of the splenium, the more rapidly the infants were able to switch their gaze.
However, in the infants who later were found to have autism, the researchers did not find any correlation between splenium size and the speed at which an infant shifted gaze. The researchers theorize that the differences in gaze shifting between the two groups may not be due directly to differences in the splenium between the groups, but to differences in a brain circuit that connects the splenium to visual areas of the brain.
Ultimately, differences in gaze detected at 7 months of age might help doctors identify children likely to develop autism later on, the authors suggested.
“By refining the gaze test and coupling it with other assessments, we hope to improve the ability to identify ASD in the first year of life,” Dr. Elison said.
An image depicting the splenium of the corpus callosum is available athttp://www.nichd.nih.gov/news/releases/Pages/032113-splenium-image.aspx.

Washington, D.C. – 3/13/2012 - The draft budget released by the House Budget Committee takes a first step toward reforming wasteful farm programs by calling for $31 billion in savings from farm subsidies and crop insurance, Environmental Working Group said in a March 12 statement.
The budget document cited record farm income over the last few years in the face of crippling federal deficits as a reason to reexamine farm subsidies and the structure of the bloated crop insurance program.
“Chairman Paul Ryan should be commended for looking to farm subsidies as ripe areas of reform that can yield large budget savings in a responsible manner,” EWG Vice President for Government Affairs Scott Faber said.
EWG has identified $100 billion that could be cut from these programs over 10 years while leaving intact a robust safety net for farmers when they need it and without harming programs that feed hungry families or protect clean water, public health and the environment.
Faber cautioned that the budget proposal would fail to achieve the planned savings if it leaves the details up to the House Agriculture Committee.
“The budget plan leaves it up to the committee to decide where the savings should come from,” Faber said. “The committee has proven time and again that it is unwilling to reduce the flow of taxpayer dollars going to the most well-off farmers.”
Following passage of last year’s budget blueprint, the House Agriculture Committee voted to take the full $35 billion in savings out of the nutrition assistance program for low income families rather than take a single penny from farm programs.
The five-year farm bill passed by the committee last summer, which never reached the House floor, would have saved only $26.6 billion over 10 years, according to the latest estimates by the Congressional Budget Office. It would have taken more than $16 billion out of nutrition and conservation programs while spending $11 billion more on federally subsidized crop insurance. Source: Environmental Working Group

(SPRINGFIELD, IL) - 3/5/2013 - The former president of a Logan County bank, Bryson John Russell, 65, of Lincoln, Illinois, today on February 27 that he had embezzled funds from the Hartsburg State Bank. During his appearance before U.S. Magistrate Judge Byron Cudmore, Russell waived indictment and entered a plea of guilty to a single count of embezzlement as charged in an information filed on February 20, 2013, by the U.S. Attorney’s Office for the Central District of Illinois. According to court documents and statements made during the hearing, the government estimates the total loss to the bank to be between $376,000 and approximately $562,292. According to statements presented by the government during today’s hearing, Russell began working at Hartsburg State Bank in Hartsburg, Illinois, in 1966. He became bank president in 1989. Russell admitted that he began taking cash from the bank to pay for personal items and obligations. At some point, Russell began creating bank loans in the names of various bank customers, including relatives. When the various loans were due, Russell created different, larger loans in relatives’ names and other bank customers’ names to pay off the loans, as well as to embezzle additional money. Further, Russell admitted cashing a customer’s $15,000 certificate of deposit and applying the proceeds to a loan he had created in the customer’s name. Sentencing for Russell is scheduled for June 27 before U.S. District Judge Richard Mills. For the offense of embezzlement, the statutory penalty is up to 30 years in prison and a fine of up to $1,000,000. The defendant may also be ordered to pay restitution to the victim. The charges were investigated by the Federal Bureau of Investigation in coordination with the Hartsburg State Bank. Assistant U.S. Attorney Patrick D. Hansen is prosecuting the case.

WASHINGTON – 3/3/2013 - Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius released a new report on February 11 showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90.
The government’s health care fraud prevention and enforcement efforts recovered a record $4.2 billion in taxpayer dollars in Fiscal Year (FY) 2012, up from nearly $4.1 billion in FY 2011, from individuals and companies who attempted to defraud federal health programs serving seniors and taxpayers or who sought payments to which they were not entitled. Over the last four years, the administration’s enforcement efforts have recovered $14.9 billion, up from $6.7 billion over the prior four-year period. Since 1997, the HCFAC Program has returned more than $23 billion to the Medicare Trust Funds.
These findings were released in the annual HCFAC Program report.
The success of this joint Department of Justice and HHS effort was made possible by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs and to crack down on individuals and entities that are abusing the system and costing American taxpayers billions of dollars. These efforts to reduce fraud will continue to improve with new tools and resources provided by the Affordable Care Act.
“This was a record-breaking year for the Departments of Justice and Health and Human Services in our collaborative effort to crack down on health care fraud and protect valuable taxpayer dollars,” Holder said. “In the past fiscal year, our relentless pursuit of health care fraud resulted in the disruption of an array of sophisticated fraud schemes and the recovery of more taxpayer dollars than ever before. This report demonstrates our serious commitment to prosecuting health care fraud and safeguarding our world-class health care programs from abuse.”
About $4.2 billion stolen or otherwise improperly obtained from federal health care programs was recovered and returned to the Medicare Trust Funds, the Treasury and others in FY 2012. This is an unprecedented achievement for the HCFAC Program, a joint Justice Department and HHS effort to coordinate federal, state and local law enforcement activities to fight health care fraud and abuse, officials said.
The administration is also using tools authorized by the Affordable Care Act to fight fraud, including enhanced screenings and enrollment requirements, increased data sharing across the government, expanded recovery efforts for overpayments and greater oversight of private insurance abuses.
Since 2009, the Justice Department and HHS have improved their coordination through HEAT and increased the number of Medicare Fraud Strike Force teams to nine. The Justice Department’s enforcement of the civil False Claims Act and the Federal Food, Drug and Cosmetic Act have produced similar record-breaking results. These combined efforts coordinated under HEAT have expanded local partnerships and helped educate Medicare beneficiaries about how to protect themselves against fraud. In FY 2012, the two departments continued their series of regional fraud prevention summits, and the Justice Department hosted a training conference for federal prosecutors, FBI agents, HHS Office of Inspector General agents and others.
The strike force teams use advanced data analysis techniques to identify high-billing levels in health care fraud hot spots so that inter-agency teams can target emerging or migrating schemes as well as with chronic fraud by criminals masquerading as health care providers or suppliers. In July, Attorney General Holder and Secretary Sebelius announced the launch of a ground-breaking partnership among the federal government, state officials, leading private health insurance organizations and other health care anti-fraud groups to share information and best practices to improve detection of and prevent payments to scams that cut across public and private payers.
In FY 2012, the Justice Department opened 1,131 new criminal health care fraud investigations involving 2,148 potential defendants, and a total of 826 defendants were convicted of health care fraud-related crimes during the year. The department also opened 885 new civil investigations.
The strike force coordinated a takedown in May 2012 that involved the highest number of false Medicare billings in the history of the strike force program. The takedown involved 107 individuals, including doctors and nurses, in seven cities, who were charged for their alleged participation in Medicare fraud schemes, involving about $452 million in false billings. As a part of the May 2012 takedown, HHS also suspended or took other administrative action against 52 providers using authority under the health care law to suspend payments until an investigation is complete.
Strike force operations in the nine cities where teams are based resulted in 117 indictments, charges and complaints against 278 defendants who allegedly billed Medicare more than $1.5 billion in fraudulent schemes. In FY 2012, 251 guilty pleas and 13 jury trials were litigated, with guilty verdicts against 29 defendants, in strike force cases. The average prison sentence in these cases was more than 48 months.
The new authorities under the Affordable Care Act granted to HHS and the Centers for Medicare & Medicaid Services (CMS) were instrumental in clamping down on fraudulent activity in health care. In FY 2012, CMS began the process of screening all 1.5 million Medicare-enrolled providers through the new Automated Provider Screening system that quickly identifies ineligible and potentially fraudulent providers and suppliers prior to enrollment or revalidation to verify the data. As a result, nearly 150,000 ineligible providers have already been eliminated from Medicare’s billing system.
CMS also established the Command Center to improve health care-related fraud detection and investigation, drive innovation and help reduce fraud and improper payments in Medicare and Medicaid.
From May 2011 through the end of 2012, more than 400,000 providers were subject to the new screening requirements and nearly 150,000 lost the ability to bill the Medicare program due to the Affordable Care Act requirements and other proactive initiatives.
The Department of Justice and HHS also continued their successes in civil health care fraud enforcement during FY 2012. The Justice Department’s Civil Division Fraud Section, with their colleagues in U.S. Attorneys’ offices throughout the country, obtained settlements and judgments of more than $3 billion in FY 2012 under the False Claims Act (FCA). These matters included unlawful pricing by pharmaceutical manufacturers, illegal marketing of medical devices and pharmaceutical products for uses not approved by the Food and Drug Administration, Medicare fraud by hospitals and other institutional providers, and violations of laws against self-referrals and kickbacks.

This marked the third year in a row that more than $2 billion has been recovered in FCA health care matters. Additionally, the Civil Division’s Consumer Protection Branch, working with U.S. Attorneys’ offices, obtained nearly $1.5 billion in fines and forfeitures, and obtained 14 convictions in matters pursued under the Federal Food, Drug and Cosmetic Act.
The HCFAC annual report is available at www.oig.hhs.gov/publications/hcfac.asp. For more information on the joint DOJ-HHS Strike Force activities, visit: www.StopMedicareFraud.gov/.